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Individual

MR. WENDELL OLIVER HACKNEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
7193 JONESBORO RD, FL 1, MORROW, GA 30260-2961
(404) 522-4888
(404) 581-0379
Mailing address
7193 JONESBORO RD, FL 1, MORROW, GA 30260-2961
(770) 961-2508
(770) 961-2378

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
024684
GA
207VG0400X
Gynecology Physician
Primary
024684
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000258871
GA
01
238229
BCBS
01
476807
AETNA
Enumeration date
04/13/2006
Last updated
03/15/2016
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